Has your partner ever complained about the noises you make in the middle of the night? Have your parents ever been woken up (on the other side of the house) by a bone-crushing sound coming from your room? Do not worry, the answer is not as ominous as the sounds may be: You might be grinding your teeth.
Teeth grinding is a quiet — well not so much quiet — killer. The grinding or clenching of teeth, known as bruxism, is unconscious but the effects are most definitely felt as it can lead to migraine, tooth sensitivity, jaw pain, poor enamel and more. But it is not something you can switch off.
The American Sleep Association reports that 10 percent of the population has bruxism. Neal Patel, D.D.S., a dentist based in Powell, Ohio, sees similar numbers in his practice. “I would estimate that about 10 percent of my patients who suffer from bruxism are aware that they grind their teeth. This percentage represents those with extreme bruxism because for them the damage has already taken place and couldn’t go unnoticed,” he says.
Because bruxism can often go undetected, Patel believes the number is actually greater than 10 percent. “In my personal practice,” he says, “I have estimated about 40 percent of my adult population suffers from some form of clenching or grinding.”
Headaches, muscle soreness and enamel abrasion are just some of the side effects. In the long term, Patel says teeth can shift, become hypersensitive, experience gum recession, and can cause jaw problems like temporomandibular joint disorder (TMD). Bruxism can also cause a person to appear older as the damage to the enamel may expedite teeth yellowing.
Most commonly, the problem is treated with a night guard or bite splint, which keep the teeth from grinding against each other. “Some bite splints are designed with specific treatment objectives such as relieving headaches and reducing TMD/TMJ pain,” says Patel.
Recently, however, a new treatment has popped up, thanks to a small study published early last year: Botulinum toxin. The study, which was published in Neurology, took a group of 22 people, 13 of whom received Botox injections and nine of whom received the placebo. The results were positive — those who received the injection reported improved symptoms.
Botox is not new. The Federal Drug Administration first approved Botox in 2002, and over seven million Botox procedures were done in 2017, according to the American Society of Plastic Surgeons.
Use of Botox for treatment of bruxism and for headache treatment is becoming more common
Patel says he first learned of Botox for dentofacial esthetics in 2002 and received training on it in 2006. “Many patients request this as an alternative to traditional dental methods in order to avoid having to wear an appliance or guard at night,” he says. “Use of Botox for treatment of bruxism and for headache treatment is becoming more common, and I now consider it to be an effective solution for many patients.”
So, how does it work? Patel says the main accomplishment is relaxing the muscles. “By proper targeting of the masseter muscle, the main muscle of the jaw, it can be relaxed enough to temporarily decrease or even stop involuntary clenching and grinding,” he says.
And, since the injection allows the muscles to relax for a period of time, Patel says the muscles become weaker, and the effects of Botox will be more long-term. With no recover time — it may take up to 10 days for the Botox to take full effect — it can last “three to five months depending on how quickly the drug is metabolized by the individual’s body,” he says.
Even though the study was small, the results were promising. And, the trend is starting to take off. While the technique is fairly new — Patel has been using it in his practice since 2010 — this could be a huge win for severe grinders. “It’s a game-changer for many patients who suffer from grinding and TMJ problems,” says Patel. “Most of my patients are thrilled to get rid of their night guards.”